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Predictive factors for unfavorable outcomes of tuberculous pericarditis in human immunodeficiency virus-uninfected patients in an intermediate tuberculosis burden country

Authors
 In Young Jung  ;  Young Goo Song  ;  Jun Yong Choi  ;  Moo Hyun Kim  ;  Woo Yong Jeong  ;  Dong Hyun Oh  ;  Yong Chan Kim  ;  Je Eun Song  ;  Eun Jin Kim  ;  Ji Un Lee  ;  Su Jin Jeong  ;  Nam Su Ku  ;  June Myung Kim 
Citation
 BMC Infectious Diseases, Vol.16(1) : 719, 2016 
Journal Title
 BMC Infectious Diseases 
Issue Date
2016
Keywords
Non-HIV ; Tuberculous pericarditis ; Unfavorable outcome
Abstract
BACKGROUND: In areas where Mycobacterium tuberculosis is endemic, tuberculosis is known to be the most common cause of pericarditis. However, the difficulty in diagnosis may lead to late complications such as constrictive pericarditis and increased mortality. Therefore, identification of patients at a high risk for poor prognosis, and prompt initiation of treatment are important in the outcome of TB pericarditis. The aim of this study is to identify the predictive factors for unfavorable outcomes of TB pericarditis in HIV-uninfected persons in an intermediate tuberculosis burden country. METHODS: A retrospective review of 87 cases of TB pericarditis diagnosed at a tertiary referral hospital in South Korea was performed. Clinical characteristics, treatment outcomes, complications during treatment, duration of treatment, and medication history were reviewed. Unfavorable outcome was defined as constrictive pericarditis identified on echocardiography performed 3 to 6 months after initial diagnosis of TB pericarditis, cardiac tamponade requiring emergency pericardiocentesis, or death. Predictive factors for unfavorable outcomes were identified. RESULTS: Of the 87 patients, 44 (50.6%) had unfavorable outcomes; cardiac tamponade (n?=?36), constrictive pericarditis (n?=?18), and mortality (n?=?4). 14 patients experienced both cardiac tamponade and constrictive pericarditis. During a 1 year out-patient clinic follow up, 4 patients required repeat pericardiocentesis and pericardiectomy was performed in 0 patients. In the multivariate analysis, patients with large amounts of pericardial effusion (P?=?.003), those with hypoalbuminemia (P?=?.011), and those without cardiovascular disease (P?=?.011) were found to have a higher risk of unfavorable outcomes. CONCLUSION: HIV-uninfected patients with TB pericarditis are at a higher risk for unfavorable outcomes when presenting with low serum albumin, with large pericardial effusions, and without cardiovascular disease.
Files in This Item:
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DOI
10.1186/s12879-016-2062-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Moo Hyun(김무현)
Kim, Yong Chan(김용찬)
Kim, Eun Jin(김은진)
Kim, June Myung(김준명)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Song, Je Eun(송제은)
Oh, Dong Hyun(오동현)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Jeong, Wooyong(정우용)
Jung, In Young(정인영)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152800
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